Assessment of Sexual Dysfunction in Male Parkinson’s Disease Patients: A Cross-Sectional Study

Background Erectile Dysfunction (ED) is a highly prevalent non-motor symptom in Parkinson’s Disease (PD), yet its vascular and hormonal factors require objective clarification. This study aimed to systematically assess ED prevalence, its association with clinical severity, cognition and quality of life (QoL), and its correlation with objective hormonal and penile hemodynamic parameters in male PD patients. Methods This cross-sectional study included 74 male PD patients. ED was quantified using the International Index of Erectile Function- 5 items (IIEF-5). Disease severity was measured by the Movement Disorder Society - Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and Hoehn and Yahr (H&Y) staging. QoL was assessed using the PDQ-39 (Parkinson’s Disease Questionnaire-39 items). Cognition was assessed using the MoCA (Montreal Cognitive Assessment). Correlations were analyzed with hormonal parameters (total/free testosterone, prolactin) and penile duplex ultrasound metrics. Results A total of 74 men suffering from PD (average age of 61 ± 8 years). ED seems to be highly prevalent, with 90.5% reporting some degree of dysfunction (mean IIEF-5: 13 ± 5). Correlations with erectile function are seen in hormonal components and duplex penile parameters, excluding prolactin and total testosterone. Older age and age at disease onset also significantly correlated with greater ED severity (p < 0.001). There was a correlation of levodopa use with diminished erectile function and lower free testosterone (all p < 0.05). There was a negative correlation between ED and quality of life. A significant association was also found between ED severity and cognitive impairment. There are negative correlations between IIEF-5 scores and UPDRS subscales and the Hoehn & Yahr stage; these scores reflect the overall burden of both motor and non-motor disease on sexual function. Conclusion ED occurs with considerable frequency in men with PD, exhibiting robust correlations with motor severity, non-motor symptom burden, hormonal dysregulation, vascular dysfunction, and diminished health-related quality of life. Contributory effects are magnified in individuals receiving levodopa therapy and in patients with later-onset disease. Collectively, these observations substantiate the heterogeneous pathophysiology of ED in the Parkinson’s cohort and accentuate the imperative for systematic sexual health screening and integrative therapeutic intervention in clinical care.